Biomedical subjects
Publications and source records attributed to I Wirguin.
In a small pilot study of plasmapheresis in chronic progressive multiple sclerosis, two patients suffered relapses following an acute allergic reaction to plasma. It is suggested that allergic reactions may have played a role in the exacerbation and recommended that fresh frozen plasma be avoided in therapeutic trials for multiple sclerosis.
Peripheral blood lymphocytes and B-cells were obtained from patients with myasthenia gravis and stimulated in vitro with either pokeweed mitogen or Epstein-Barr virus (EBV), respectively. EBV stimulation of B-cells caused a production of antibodies to acetylcholine receptor in 15 of the 25 myasthenia gravis patients: the EBV stimulation of B-cells was more effective in this regard than the pokeweed mitogen stimulation of peripheral blood lymphocytes. The in vitro synthesis of anti-acetylcholine receptor antibodies was found to be positively correlated with both the patients' sera antibody titers and with the disease severity.
Three children with subacute sclerosing panencephalitis (SSPE) were treated with alpha-interferon. Medication was administered via an Ommaya reservoir into the cerebral ventricular system over a period of 13 to 24 months in increasing amounts up to 1.0 x 10(6) IU twice weekly. Mild clinical improvement in two children and a stable course in the third were associated with improvement of electroencephalographic recordings in all patients and a decrease in antimeasles antibodies in the cerebrospinal fluid of two. The small number of patients does not enable us to determine whether this course was the natural history of SSPE in our patients or whether it was induced by treatment, yet it seems that intraventricular interferon treatment can modify the course of SSPE.
Subacute sclerosing panencephalitis developed during pregnancy in a 27-year-old woman and immediately after delivery in an 18-year-old woman. In both, disease took an acute and fulminant course culminating in a vegetative state within several weeks. It is suggested that the relative older age of disease presentation and the unusually rapid neurologic deterioration were partially due to immunologic and hormonal alterations of pregnancy.
In five patients with peripheral neuropathy due to vitamin B12 deficiency, electrodiagnostic studies demonstrated severe reduction in sensory nerve conduction velocities compatible with a demyelinating disorder affecting sensory nerve fibres. It is suggested that in some patients lack of vitamin B12 may cause primary sensory demyelinating neuropathy.
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A family with 12 children, 6 of whom had Sjögren-Larsson syndrome, was studied clinically. On CT, all six siblings with the disease had patchy regions of white matter hypodensity, most marked in the frontal lobes, which were confluent in the more severe cases. The ventricles were not enlarged and no other abnormality was demonstrated. The CTs of the 6 unaffected siblings and the mother, who was also unaffected by the disease, were normal.
Three patients developed acute Guillain-Barré syndrome while on steroid treatment. The first patient suffered from ulcerative colitis and developed Guillain-Barré syndrome when the steroid dosage was being tapered. Another patient with long-standing multiple sclerosis received steroids during relapse and the Guillain-Barré syndrome appeared while treatment was reduced. The third patient, with aqueductal stenosis and ventriculoatrial shunt, who received steroids when malfunction of the shunt was suspected, developed Guillain-Barré syndrome while steroids were being tapered. Based on the putative immune pathogenesis of inflammatory demyelinating polyneuropathy, the occurrence of the syndrome in these patients could have been due to a selective effect of low-dose steroids on a specific, maybe suppressor lymphocyte subpopulation.
The effect of delta 8-THC on experimental autoimmune encephalomyelitis (EAE) was examined. delta 8-THC is an analogue of delta 9-THC, the psychoactive component of marijuana. It is more stable and less psychotropic than delta 9-THC and like the latter it binds to the brain cannabinoid receptor. Two strains of rats were inoculated for EAE, and delta 8-THC (40 mg/kg) was administered for up to 21 days. delta 8-THC significantly reduced the incidence and severity of neurological deficit in both rat strains. The beneficial influence of delta 8-THC only occurred on oral administration and not with parenteral injection. Serum corticosterone levels were twofold elevated in rats with EAE chronically treated with delta 8-THC. These results suggest that suppression of EAE by cannabinoids may be related to their effect on corticosterone secretion.